Kate B Savoie1, Marielena Bachier-Rodriguez1, Tamekia L Jones2, Kristen Jeffreys1, Dita Papraniku3, Wednesday Marie A Sevilla4, Emma Tillman5, Eunice Y Huang1. 1. 1 Division of Pediatric Surgery, Department of Surgery, University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, Tennessee, USA. 2. 2 Children's Foundation Research Institute, Departments of Pediatrics & Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA. 3. 3 Dietetics and Nutrition, Le Bonheur Children's Hospital, Memphis, Tennessee, USA. 4. 4 Division of Pediatric Gastroenterology, Department of Pediatrics, University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, Tennessee, USA. 5. 5 Department of Clinical Pharmacy, Indiana University Health, Riley Hospital for Children, Indianapolis, Indiana, USA.
Abstract
BACKGROUND: Postabdominal intestinal surgery (PAIS) infants pose many complex management issues. Utilization of feeding guidelines has been shown to improve outcomes in preterm and low-birth-weight infants. We propose that standardization of feeding for PAIS infants is safe. METHODS: We identified 163 PAIS infants: 93 prior to and 70 after implementation of a feeding guideline. The primary outcome was time to full enteral nutrition (EN). A propensity score-matched analysis was performed. RESULTS: The preimplementation and postimplementation PAIS infants were similar at baseline. No significant differences were seen in matched groups for time to full EN, parenteral nutrition days, or time to discharge, but cholestasis was less severe in the postimplementation group and breast milk use increased. Good compliance (67%) to daily guideline use was achieved during the initial 2 years. CONCLUSIONS: Utilization of a feeding guideline is safe and standardizes care within an institution, improving compliance to evidence-based practices and outcomes.
BACKGROUND: Postabdominal intestinal surgery (PAIS) infants pose many complex management issues. Utilization of feeding guidelines has been shown to improve outcomes in preterm and low-birth-weight infants. We propose that standardization of feeding for PAIS infants is safe. METHODS: We identified 163 PAIS infants: 93 prior to and 70 after implementation of a feeding guideline. The primary outcome was time to full enteral nutrition (EN). A propensity score-matched analysis was performed. RESULTS: The preimplementation and postimplementation PAIS infants were similar at baseline. No significant differences were seen in matched groups for time to full EN, parenteral nutrition days, or time to discharge, but cholestasis was less severe in the postimplementation group and breast milk use increased. Good compliance (67%) to daily guideline use was achieved during the initial 2 years. CONCLUSIONS: Utilization of a feeding guideline is safe and standardizes care within an institution, improving compliance to evidence-based practices and outcomes.